What Causes Kussmaul Respirations In Dka?

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Starvation Ketoacidosis: A Cause Of Severe Anion Gap Metabolic Acidosis In Pregnancy

Copyright © 2014 Nupur Sinha et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Pregnancy is a diabetogenic state characterized by relative insulin resistance, enhanced lipolysis, elevated free fatty acids and increased ketogenesis. In this setting, short period of starvation can precipitate ketoacidosis. This sequence of events is recognized as “accelerated starvation.” Metabolic acidosis during pregnancy may have adverse impact on fetal neural development including impaired intelligence and fetal demise. Short periods of starvation during pregnancy may present as severe anion gap metabolic acidosis (AGMA). We present a 41-year-old female in her 32nd week of pregnancy, admitted with severe AGMA with pH 7.16, anion gap 31, and bicarbonate of 5 mg/dL with normal lactate levels. She was intubated and accepted to medical intensive care unit. Urine and serum acetone were positive. Evaluation for all causes of AGMA was negative. The diagnosis of starvation ketoacidosis was established in absence of other causes of Continue reading >>

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Popular Questions

  1. SVL

    So I understand this to be deep rapid respirations, as part of the signs of DKA. It's a result of the acidosis, and a need for air... so the body rapidly tries to expel CO2.
    So... how on earth do you treat the respirations? I do understand you would need to treat the acidosis, but the question on my study guide says to know how to treat Kussmaul's Respirations.
    A class mate told me with a brown paper bag? That doesn't seem complicated enough to me, and I can't find anything in my book about it.

  2. Guest

    You have to treat the acidosis first and if that doesn't correct it--Intubation. I don't know Sarah usually when they get to that point they are on their way out.

  3. BlueRidge

    Your classmate is confusing Kussmaul's with hyperventalation, which is caused by breathing too deeply and/or quickly. Hyperventalating leads to the UNINTEDED loss of of too MUCH CO2, leading to dizziness and tingling of extremities. That treatment IS the brown paper bag or breathing into cupped hands to rebreath in more CO2. This occurs with overexcitment or during labor with controlled breathing patterns (like Lamaze).
    As you said, Kussmaul's is an attempt to reverse metabolic acidosis by blowing off Bicarb as a compensatory effort. These are spontaneous and under autonamic control, so you can NOT "treat the respirations" any more than you can help a patient "control" full blown labor contractions or autonamic dysreflexia in a pt with spinal cord injury.
    So, as TNN said, the treatment is to control the underlying metabolic issue with meds, fluids, mechanical oxygenation if needed. Th pH has to brought up to a level compatable with human life.

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